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- Title
Morphometric study of arterioles and glomeruli in the aging kidney suggests focal loss of autoregulation<sup>1</sup>.
- Authors
Hill, Gary S.; Heudes, Didier; Bariéty, Jean
- Abstract
Morphometric study of arterioles and glomeruli in the aging kidney suggests focal loss of autoregulation. Background. In the past it was widely assumed that hyaline afferent arteriolosclerosis was responsible for ischemic glomerulosclerosis in the aging and hypertensive kidney. However, glomerular lesions of focal segmental glomerulosclerosis are now recognized in essential hypertension. Experimentally, such lesions are associated with loss of autoregulation of blood flow and glomerular hyperperfusion, as well as initial glomerular hypertrophy. These observations challenge the notion of ischemia as a unitary explanation for glomerulosclerosis. Methods. A morphometric study was performed on normal portions of eight kidneys removed for tumors in aging, normotensive patients. Measurements were made of 126 pairs of afferent arterioles and their associated glomeruli. In addition, the amount of extracellular matrix (ECM) in the immediate periglomerular region was quantitated. Results. Afferent arterioles were divided into three types according to the presence or absence of hyaline deposits and whether these did or did not obstruct the lumen. Arterioles with nonobstructive hyaline deposits had lumens over twice as large as those without deposits (482 ± 240 μ2 vs. 204 ± 160 μ2 , P = 0.0000). Their associated glomeruli had significantly greater total capillary area, particularly the hilar capillaries (1276 ± 797 μ2 vs. 667 ± 492 μ2 , P = 0.002), but with larger individual capillaries elsewhere as well (P = 0.03). Arterioles with obstructive deposits differed from those with nonobstructive deposits by their smaller lumens (P = 0.001) and walls (P = 0.004), with a higher proportion of ECM in the periglomerular region (P = 0.001), all consistent with a later stage of lesion. Glomeruli were divided into four basic types: normal, hypertrophic, glomeruli with features of focal segmental...
- Subjects
KIDNEY glomerulus; KIDNEY diseases
- Publication
Kidney International, 2003, Vol 63, Issue 3, p1027
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2003.00831.x